A Cross-Sectional Study of the Microeconomic Impact of Cardiovascular Disease Hospitalization in Four Low- and Middle-Income Countries
Population
1,657 recently hospitalized cardiovascular disease patients, mean age 55.8 years, 66% male, from Argentina…
Design
Cross-sectional
Follow-up
15 months
Authors
Discussion
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Member takes
Implication
Signals urgent need for financial protection in LMIC CVD care; leaves open whether expanding insurance reduces catastrophic spending.
Key Points
- To quantify the microeconomic, functional, and productivity impacts of cardiovascular disease hospitalization on individuals and their households across four low- and middle-income nations.
- Surveyed 1,657 recently hospitalized cardiovascular disease patients (66% male; mean age 55.8 years) across Argentina, China, India, and Tanzania.
- Stratified respondents into three income categories and evaluated out-of-pocket healthcare expenditures, distress financing, and work productivity loss across a 15-month follow-up period.
- Median out-of-pocket spending over 15 months ranged from 354 international dollars in Tanzania to 2,917 international dollars in India, with catastrophic health spending occurring in over 50% of patients in China, India, and Tanzania.
- Lack of health insurance independently increased the risk of catastrophic health spending in Argentina (OR 4.73, 95% CI [2.56, 8.76]), India (OR 3.93, 95% CI [2.23, 6.90]), and Tanzania (OR 3.68, 95% CI [1.86, 7.26]), with a marginal association in China (OR 2.05, 95% CI [0.82, 5.11]).
- Economic distress coincided with substantial losses in household income and marked declines in patient functional health and physical productivity.
Structured PICO
P
Population
1,657 recently hospitalized cardiovascular disease patients, mean age 55.8 years, 66% male, from Argentina, China, India, and Tanzania.
O
Outcome
Microeconomic and functional/productivity impact of CVD hospitalization (including out-of-pocket expenditures, catastrophic health spending, distress financing, and lost income)patient reported
Hospitalization for cardiovascular disease in low- and middle-income countries imposes a severe financial burden, with catastrophic health spending affecting over half of patients in some nations, largely exacerbated by a lack of health insurance.
Cite This Study
Huffman et al. (2011) studied this question.